The role of the pharmacist in improving adherence to inhaled medication among COPD patients

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Aljahan, Abdullah M ORCID: https://orcid.org/0000-0001-7014-0015 (2023). The role of the pharmacist in improving adherence to inhaled medication among COPD patients. University of Birmingham. Ph.D.

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Abstract

Background: COPD is not a single health problem, but a spectrum of diseases associated with airway obstruction. Adherence to inhaler medication is critical but remains sub-optimal amongst COPD patients. Intervention studies suggest pharmacists could play an important role in improving patients’ adherence, but there is a lack of integration of pharmacists within primary care. Despite the potential benefits of community pharmacists in improving adherence/inhaler technique amongst respiratory patients, community pharmacists are an untapped resource. In this thesis, I explore the current practice of UK pharmacists in promoting adherence to inhaler medications for COPD patients, and their views, and those of patients and primary healthcare practitioners on how pharmacists might best be involved in their care pathway.

Aim: To explore the role of the pharmacist in improving adherence to inhaled medication among COPD patients.

Methods: Five studies were conducted to fulfil the aim of this thesis. These involved a) a cross- sectional study to ascertain community pharmacists’ knowledge, attitude and current practice and explore views on their role to improve inhaler adherence among COPD patients; b) three qualitative studies exploring COPD patients’ perspectives on the role of pharmacists in the management of COPD patients, HCPs’ perspectives on the current role of pharmacists and their integration in the management of COPD, and both patients’ and HCPs’ perspectives on COVID-19 and its impact on healthcare services provided to COPD patients; c) a systematic review of pharmacist role in Shared Decision Making (SDM) for patients with long-term conditions.

Results: This PhD identified a potential willingness from UK pharmacists to help COPD patients by offering high-quality services as most community pharmacists have a solid foundation of knowledge about inhalers. Many HCPs and patients believe pharmacists would benefit from being more involved in their patients’ treatment plans. However, patients’ and HCPs’ perceptions on the role of pharmacists highlighted their limited capacity, the limited collaboration and communication between HCPs and pharmacists as well as HCPs and patients, and regulatory hurdles such as lack of access to medical records.

Conclusion: This PhD highlighted the potential pharmacists’ roles in supporting COPD care delivery. However, the results showed some aspects where barriers must be overcome to facilitate this role. Hence, this PhD proposes that future work should concentrate on these aspects to make it more possible to step up the pharmacists’ roles and eventually improve adherence to inhaled medication among COPD patients within the UK.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):